TY - JOUR
T1 - Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma
T2 - A retrospective study
AU - Yan, Jiun Lin
AU - Chang, Chen Nen
AU - Chen, Pin Yuan
N1 - Publisher Copyright:
© 2021 Yan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/8
Y1 - 2021/8
N2 - Background The endoscopic transsphenoidal approach is an efficient minimally invasive procedure for removal of pituitary tumors that can be accomplished through a one-hand or two-hand approach. The one-hand procedure through one nostril is more intuitive for surgeons, but maneuvering the instruments can be restrictive. The two-hand procedure using a one-andhalf nostril approach provides more precise manipulation. This study aimed to compare the surgical outcomes of one-hand/mono-nostril and two-hand/one-and-half nostril surgeries for resection of large pituitary tumors by a single neurosurgeon. Materials and methods The surgical data of 78 consecutive cases with pituitary macroadenoma (diameter >1 cm) were reviewed retrospectively. Altogether, 30 cases received one-hand/mono-nostril surgery, while 48 cases received two-hand/one-and-half nostril surgery. Postoperative outcomes of the two operations were compared. Results The operative time, hospital stay, residual rate of pituitary macroadenoma, visual field, surgical complications, and re-operative rates were slightly improved in the two-hand/one-andhalf nostril surgery group compared with that in the one-hand/mono-nostril surgery group (all p>0.05). However, postoperative hypopituitarism was less frequent (1/48; 2.0%) with the two-hand/one-and-half nostril approach than with the mono-nostril approach (p = 0.004). Similar surgical outcomes were found in all patients with either small or large pituitary tumors, except that the difference in postoperative improvement in visual field change reached statistical significance (p = 0.044). Conclusion A single-surgeon endoscopic endonasal transsphenoidal surgery with two-hand/one-andhalf nostril approach is an effective and safe procedure for removal of large pituitary tumors.
AB - Background The endoscopic transsphenoidal approach is an efficient minimally invasive procedure for removal of pituitary tumors that can be accomplished through a one-hand or two-hand approach. The one-hand procedure through one nostril is more intuitive for surgeons, but maneuvering the instruments can be restrictive. The two-hand procedure using a one-andhalf nostril approach provides more precise manipulation. This study aimed to compare the surgical outcomes of one-hand/mono-nostril and two-hand/one-and-half nostril surgeries for resection of large pituitary tumors by a single neurosurgeon. Materials and methods The surgical data of 78 consecutive cases with pituitary macroadenoma (diameter >1 cm) were reviewed retrospectively. Altogether, 30 cases received one-hand/mono-nostril surgery, while 48 cases received two-hand/one-and-half nostril surgery. Postoperative outcomes of the two operations were compared. Results The operative time, hospital stay, residual rate of pituitary macroadenoma, visual field, surgical complications, and re-operative rates were slightly improved in the two-hand/one-andhalf nostril surgery group compared with that in the one-hand/mono-nostril surgery group (all p>0.05). However, postoperative hypopituitarism was less frequent (1/48; 2.0%) with the two-hand/one-and-half nostril approach than with the mono-nostril approach (p = 0.004). Similar surgical outcomes were found in all patients with either small or large pituitary tumors, except that the difference in postoperative improvement in visual field change reached statistical significance (p = 0.044). Conclusion A single-surgeon endoscopic endonasal transsphenoidal surgery with two-hand/one-andhalf nostril approach is an effective and safe procedure for removal of large pituitary tumors.
UR - http://www.scopus.com/inward/record.url?scp=85112665843&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0255599
DO - 10.1371/journal.pone.0255599
M3 - 文献综述
C2 - 34358251
AN - SCOPUS:85112665843
SN - 1932-6203
VL - 16
JO - PLoS ONE
JF - PLoS ONE
IS - 8 August
M1 - e0255599
ER -